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Syncope (blackout) is a common Emergency Department (ED) problem but the diagnosis is not apparent in two third of patients. Serious outcome is 7% at one month and 15% at one year. Many of these are cardiovascular and due to abnormal heart rhythms, difficult for clinicians to diagnose as examination and ECG may both be normal and symptoms resolved by the time the patient gets to ED. Diagnosing an abnormal heart rhythm as the cause of blackout rests on correlating it with symptoms using monitoring devices but these are problematic, not widely available and only record for 48 hours. We believe ambulatory patches will allow earlier abnormal heart rhythm detection and revolutionised blackout care.